Surgical retractor



June 1953 H..:iM. JACKSON 2,642,862

summon. RETRACTOR Fil ed re. 25, 1952 lnnentor:

HENRY M. JACKSON,

Patented June 23, 1953 UNITED STATES PATENT. OFFICE.

Henry M. Jackson, Salt Lake City, Utah Application February 25, 1952,Serial No. 273,176

, 2 Claims. 1

This invention relates to surgical instruments, and particularly to thetype of instrument known as a retractor.

Retractors are commonly used in surgery to maintain an incision openduring'an operation, so that the surgeon may work unhampered and withfree access to the opening. Existing constructions are well adapted tosurgical operations on certain parts of the body, for example, therectum, but I have found none adapted to thyroid and to other surgery ofthe neck and generally similar parts of the body where the particularbody contour presents special problems.

A principal object, then, of this invention is to provide a surgicalretractor peculiarly adapted to neck surgery and the like, one whichwill effectively accomplish the purpose sought, without itselfinterfering with free access of the surgeon to the operative opening,and one which can be quickly and easily applied and removed and adjustedfor any given instance of use.

Most surgical retractors embody a pair of jaws, one of which isadjustably mounted relative to the other for separation over arequireddistance and for anchorage in any given adjusted position. The jaws areequipped with fleshgripping formations of one kind or another extendingtherefrom.

The instrument of the invention is'similar in some respects to existingconstructions, but introduces new structural features and relationships,which, despite their simplicity, solve problems long existing in certaintypes of surgery, especially surgery of the neck.

In accordance with the invention, a pair of elongate jaws, equipped withflesh retraction members projecting laterally therefrom in mutualopposition, are pivoted to and form articulative extensions ofrespective arms,-which, themselves, extend laterally from and are eachslideably mounted on an elongate slideway, preferably a bar of polygonalcross-section which precludes rotation of the arms thereon. The jaws arepivoted on respective axes which are substantially parallel with theslideway, so that the body of the retractor will drop down beside theneck, or other body part concerned, and lie in substantial parallelismtherewith closely thereagainst and well below the level of the openincision. Thus, the margins of the incision are effectively andpositively held in retracted position, providing a widely opened areafor surgical manipulations, while the retracting instrument, itself, inno way obstructs or otherwise interferes with the activities of thesurgeon.

- fitting fit.

2 Further objects and features of theinvention will become apparent fromthe following detailed description of preferred specific embodimentsthereof, as illustrated in the accompanying drawing.

In the drawing: Fig. 1 represents a top plan view of the retractor ofthe invention in position for retractin the margins of a customary neckincision in thyroid surgery;

Fig. 2, a similar view, but showing the position assumed by theretractor in accomplishing Fig. 4, a bottom plan view of the retractorper se;

Fig. 5, a fragmentary elevation looking from the right'in Fig. 4;

Fig. 6, a section, taken in the line .6--6 of Fig. 5; i

Fig. 7, a. fragmentary view corresponding genorally to that of Fig. 6,but illustrating an embodiment equipped with somewhat different jaws,for more general use, as for example, in conneo tionwith vein ligature;and I Fig. 8, a fragmentary view corresponding generally to that of Fig.5, but with respect to the embodiment of Fig. 7.

Referring to the drawing: 7

The instrument shown in Figs. 1 through 6 is adapted primarily forthyroid surgery, as illustrated in Figs. 1 and 2. I

In theform illustrated, it comprises a-slideway bar l0, shown as havinga square cross section and headed ends Illa. Slideably mounted on suchslideway bar between the headed ends I ha, and projecting laterally fromthe bar, is a pair of jaw- -carrying arms II and I2, the mounting beingpreferably accomplished by means of respective end portions Ila and |2aformed as sleeves for fitting over the slideway bar in close Respectiveset screws I3 are advantageously provided for positively locking thearms H and I! in any given relative positions on the slideway bar.

Pivotally secured to the outer ends of the arms II and H, as by means ofpins I4 and I5, are respective retractor jaws l6 and H, constituting anoperative pair of jaws for tissue retractive purposes. Such jaws I6 andH are preferably formed with respective opposing sets of depending,curved teeth, lGa and Ila, which are arranged in mutually spacedrelationship along the length of the outer end portions of the jaws. Asso formed and arranged, the teeth Ilia and I Ia correspond to retractorteeth heretofore used with conventional retractor instruments, andnothing new is claimed for their use as such.

Not conventional, however, is the pivotal mounting of the jaws I6 and ITon the respective arms II and I2, which, in combination with theretractor teeth or other grasping formations extending laterally of thejaws proper, enable the instrument to accomplish the desired results; Itshould be noted that the pivot axes represented by the pins I4 and I5are aligned end-toend, and are parallel with theslideway bar I0.

Thus, the instrument provides for free swinging,-

relative movement between the jaws I6 and IT and the assembly ofslideway bar I and carrying:

arms I I and I2, about the pivot pins I4 and I as a longitudinallyextending; center.

This feature: is of great. importance in the useoftheinstrument. as-canbe easily seen from the showing. ofFig. 3,since.it enables theslidewayand carrying arms to hang down against the neck, out of the way of thesurgeon, during thyroid or similar surgery.

Contributing materially to the functional effectiveness of the retractorin this connection, is the fact that both carrying arms II and I2 areslideable relative to the slideway bar I0. As so constructed, theslideway bar and carrying arms may be freely adjusted; in positionrelative-to oneanother andto the neck of the patient, prior to andfollowing the. positioning of the jaws IS and, ITl-inthe incision I8;Figs. 1 and 2.

When, the jaws are: manually forced apart to properly retract skin andother tissues at the margins; ofthe incision, asshown inlFig. 2, the setscrews I3 are usually tightened to positively insure against; slippageof; the; arms. on the. slideway bar during surgery. This is not alwaysnecessary, however. since: the tendencyfor the retracted tissues toreturn to their normal positions will exert pressure onthe jaws, whichwill normally-cause; the sleeves II a and I2a to; bind tightlyagainstslippage on the slideway bar.

It' should be noted that; due to the unique construction of theinstrument of the invention, completely effective retraction of thetissues concerned is had, and no'partsofithe instrument are in aposition to in any way impede or obstruct the surgical procedure.Furthermore, the instrumentis quickly and easilyapplied and retendinggrasping members of different formation than the teeth I6a and IIa.Thus, as illustrated in Fig. 7, jaws having elongate and opposinglycurved loop members 20, instead of a series of sharp fingers, may beemployed for various surgical purposes, such as vein ligature in thelegs.

Whatever the formation of the retractor jaws, however, as dictated bythe particular use desired for the instrument, the distinctivestructural features of the instrument, as outlined above, render itcapable of achieving results heretofore unrealized in surgicaltechniques.

Whereas this invention is here illustrated and described with respect toparticular preferred forms-thereof, it should be realized that variouschangesthereinand various other forms may be resorted to by thoseskilled in the art, on the basis of the teachings hereof, withoutdeparting from the cope of the claims which here follow.

I claim;

1. Asurgiaalretractor made up of an elongate slideway bar, and a pair ofelongate jawcarrying arms mounted inmutually opposed. relationship onand extending laterally from and transversely to the. said slideway bar,said retractor being characterized by the fact that the jawsformlongitudinal extensions of the respective arms, and are pivoted infree-swinging relationship to the-free ends of said arms on axes whichare substantially aligned end-to-end and substantially parallel with theslideway bar; and by the further fact that flesh-retracting membersextend laterally from and transversely of the jaws.

2. Asurgical-retractor made up of an elongate slideway bar, and a pair,of; elongate jaw-carrying arms mounted in mutually opposed relationshipon and extendinglaterally from and transversely to thesaid slideway bar,said retractor being characterized by the fact that the jaws formlongitudinal extensions of the respective arms, and arepivotedinfree-swinging relationship to the free ends of said arms on axes whichare substantially aligned end-to-end and substantially parallel with theslideway bar; by the further fact that flesh-retracting members extendlaterally from and transversely of the jaws; and by the further factthat both of said retractor. arms are slidable on the slideway barrelativeto; it andto, each other.

HENRY. M. JACKSON.

References Cited; in. the file of this patent UNITED. STATES PATENTSName: Date Bessesen May 22, 1923 OTHER, REFERENCES Number 1,456,116

